Psychotic Symptoms, Mystical Experiences: Applying the Methodologies of St. Teresa of Avila to Contemporary Clinical Practice

Psychiatrists are likely to attribute any religious experiences of a patient to delusion or immature coping mechanisms, so it is no surprise that when patients present experiences that do not conform to conventional ideas of reality testing, psychiatrists are quick to diagnose them as a psychotic. Even for clinicians open to the spiritual dimension in their patients, this situation can be challenging. Discerning whether a patient is having a mystical experience or a psychotic episode is crucial to the direction of treatment.

This paper employs the methodology of 16th century mystic and Doctor of the Church St Teresa of Avila to evaluate mystical experiences by their "fruit" and not by their manifest content. I will present three clinical cases. In the first case the religious experiences were psychotic and required hospitalization and medication management. In contrast, the second showed that unusual religious experiences could be a vehicle for transformation. Medicating this patient with antipsychotic drugs would have been decidedly non-therapeutic. Psychoanalyic psychotherapy exploring the deep significance of the visions allowed her to leave an abusive marriage and return to her career as an artist. The third case shows mixed elements where a young man became able to use mysticism as a frame to live with creativity and generativity in the face of a psychotic disorder. Taken together, these cases provide a rich range of experiences, and demonstrate that being able to differentiate mystical experience from psychosis is imperative to achieving optimal treatment outcomes.